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by Mary Elizabeth Dallas

Scientists Discover New Way to Make Human Platelets

Findings could one day help meet increasing global demand for blood transfusions, researchers say
MONDAY, July 21, 2014 (HealthDay News) -- Scientists report they have discovered a new way to make fully functional human platelets, which are the blood cells that form clots.
Using human stem cells and a device called a bioreactor, which mimics the body's natural way of producing blood cells but on a larger scale, the researchers said their method eliminates risks and complications associated with donor blood transfusion. Those include a five-day shelf-life, contamination, rejection and infection. They added that their findings could help meet increasing global demand for donor blood.
"The ability to generate an alternative source of functional human platelets with virtually no disease transmission represents a paradigm shift in how we collect platelets that may allow us to meet the growing need for blood transfusions," study author Jonathan Thon, from the division of hematology at Brigham and Women's Hospital in Boston, said in a hospital news release.
Blood cells, such as platelets, are made in bone marrow. The bioreactor, the researchers explained, combines the major components of bone marrow and models its composition and blood flow characteristics.
"By being able to develop a device that successfully models bone marrow represents a crucial bridge connecting our understanding of the physiological triggers of platelet formation," study senior author Joseph Italiano Jr., of the division of hematology at Brigham and Women's Hospital and the Vascular Biology Program at Boston Children's Hospital, said in the news release.
The researchers hope to begin human clinical trials in 2017.
"The regulatory bar is appropriately set high for blood products, and it is important to us that we show platelet quality, function and safety over these next three years since we'll likely be recipients of these platelets ourselves at some point," Thon said.
One expert agreed the findings could change the way platelets are collected.
"A major factor that has limited our ability to compare bioreactor platelets to donor platelets is the inefficiency of growing platelets, a problem that slows progress of clinical research," Dr. William Savage, medical director of the Kraft Family Blood Donor Center at Dana Farber Cancer Institute/Brigham and Women's Hospital, said in the news release. He was not part of the study. "This study addresses that gap, while contributing to our understanding of platelet biology at the same time."
In the United States, more than 2.17 million platelet units from donors are transfused each year to treat trauma patients and those undergoing chemotherapy, organ transplants and surgery, the researchers noted.
The study, published July 21 in the journal Blood, was partially funded by the U.S. National Institutes of Health. Thon and Italiano are co-founders of Platelet BioGenesis, a company that aims to produce donor-independent human platelets from human stem cells.
More information
The U.S. National Institutes of Health provides more information on blood transfusions and donations (http://www.nlm.nih.gov/medlineplus/bloodtransfusionanddonation.html ).
SOURCE: Brigham and Women's Hospital, news release, July 21, 2014
by Mary Elizabeth Dallas

Animal Experiments Shed Light on HIV's Ability to Hide

Viral 'reservoir' in body develops earlier than thought, thwarting attempts at cure, scientists say
MONDAY, July 21, 2014 (HealthDay News) -- The "viral reservoir" in which HIV can lie dormant for years, avoiding detection and elimination, is established much earlier than previously thought, new animal research indicates.
This discovery poses new obstacles for those working to eradicate the AIDS-causing virus, said Harvard researchers working with the U.S. Military HIV Research Program. They said the presence of the viral reservoir remains the most significant challenge to finding a cure for a subtype of HIV, known as HIV-1.
"We found that the reservoir was established in tissues during the first few days of infection, before the virus was even detected in the blood," said the study's senior author, Dr. Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston.
For the study, published online July 20 in Nature, rhesus monkeys were infected intrarectally with simian immunodeficiency virus (SIV). SIV is believed to be the precursor of HIV in humans.
The researchers began antiretroviral therapy in groups of monkeys at three, seven, 10 and 14 days after they were infected with SIV.
Animals treated after three days showed no evidence of the virus in their blood and did not have an immune response to SIV. Despite six months of therapy, however, all of the animals had resurgence of the virus once treatment was stopped.
The investigators found that the earlier the treatment began, the longer it took for the virus to rebound, or become detectable in the blood. Still, the researchers concluded other strategies are needed to effectively cure HIV infection.
"The strikingly early seeding of the viral reservoir within the first few days of infection is sobering and presents new challenges to HIV-1 eradication efforts," the study authors wrote. The data suggest that extremely early initiation of [antiretroviral treatment], extended treatment and probably additional approaches that activate the viral reservoir will be required for HIV-1 eradication, they said.
The findings were reported in the wake of news that a Mississippi baby who was thought cured of HIV after receiving early antiretroviral therapy experienced a resurgence of the virus.
"The unfortunate news of the virus rebounding in this child further emphasizes the need to understand the early and refractory viral reservoir that is established very quickly following HIV infection in humans," added Barouch, a professor of medicine at Harvard Medical School in Boston, in a medical center news release.
Results of animal experiments aren't necessarily applicable to humans.
More information
The U.S. Department of Health and Human Services has more about HIV/AIDS (http://www.aids.gov/hiv-aids-basics/ ).
SOURCE: Beth Israel Deaconess Medical Center, news release, July 20, 2014
by Mary Elizabeth Dallas

Asthma Drug May Help Those With Chronic Hives

Xolair found safe, effective for reducing symptoms, study finds
MONDAY, July 21, 2014 (HealthDay News) -- A drug already used to treat moderate-to-severe allergic asthma appears to offer relief to people with chronic hives who haven't been helped by standard medications, new research suggests.
The prescription drug -- omalizumab (Xolair) -- is already available to treat hives, following U.S. Food and Drug Administration approval earlier this year for that use.
The current study confirms that when Xolair is taken at a high dose for a six-month period it seems to be both safe and effective at controlling the severe and often debilitating itching that characterizes long-term hives.
"So what we're talking about here are only chronic cases, in which patients have hives that last for more than six weeks," explained study senior author Dr. Karin Rosen, an associate group medical director with Genentech Inc., in San Francisco. "That's usually just .5 to 1 percent of hives patients."
"But for those patients, this is a really horrible disease," she noted. "And until now antihistamines have been the only approved drug for chronic hives. But to work, antihistamines often need to be used at up to four times approved levels, which has a sedating effect. And 50 percent of the time patients didn't respond anyway."
"So then," said Rosen, "they would try other types of medications, like systemic steroids. But over time steroids can have very severe side effects. So then we would turn to the heavy artillery, like [the immunosuppressant drug] cyclosporine, which also has very severe side effects, and can't be taken by people with high blood pressure or heart disease."
"All this means that many, many patients have simply been left without any treatment," she noted. "But with this drug we are seeing great improvement in patients who previously had no options. And that's very, very encouraging."
Rosen and her colleagues discuss their findings in the July 21 issue of the Journal of Investigative Dermatology. The current study is the latest in a series of ongoing studies, which are being funded by drug manufacturer Genentech Inc. and Novartis Pharma AG in Basel Switzerland.
While not lethal, chronic hives can last for months, and tend to come and go without a clear idea of what brings it on. And, Rosen noted that almost half of chronic hive patients also have angioedema, a "scary and deforming" condition that involves deep tissue swelling, often affecting the eyes and the tongue.
To explore Xolair's potential, the team tested its effectiveness among more than 260 chronic hives patients for whom prior treatment had failed.
Patients were randomly divided into four groups, in which they were respectively treated with a once-a-month injection of Xolair at either a 75 milligram (mg) dose, a 150 mg dose, a 300 mg dose, or a dummy shot.
Tracking was conducted for both a three-month period and a six-month period.
The team found that by the 12th week, people given Xolair showed a marked reduction in their overall number of hives, hive intensity and itching severity, compared with patients who got the dummy treatment. And Rosen noted that roughly 40 percent saw a complete disappearance of all symptoms, while 80 percent experienced "what we call minimally important improvement."
Symptom relief was maintained through the six-month mark, and the authors determined that those treated with the highest (300 mg) dosage of Xolair saw the biggest improvement.
Side effects were described as being mild to moderate, and included headaches, joint pain, sinus infection and reactions at the point of injection.
The study authors acknowledged that more research will be needed to see how the drug performs over longer periods of time.
Dr. Robert Kirsner, chair of the department of dermatology and cutaneous surgery and chief of dermatology at the University of Miami Miller School of Medicine, suggested that the new intervention could prove to be a boon for a condition that "can significantly affect patients' quality of life."
"Patients suffer from this severe, recurrent itching, and it is a challenge for clinicians to find treatments that can help," he noted. "The data related to omalizumab use, in a well-performed randomized clinical trial, is extremely promising and offers hope for patients who have chronic [hives], and for the physicians who care for them."
More information
Visit the Asthma and Allergy Foundation of America (http://www.aafa.org/display.cfm?id=9&sub=23&cont=328 ) for more on hives.
SOURCES: Karin Rosen, M.D., Ph.d., associate group medical director, Genentech, Inc., San Francisco; Robert Kirsner, M.D., Ph.D., professor, vice chairman and chair, department of dermatology and cutaneous surgery, and chief, dermatology, University of Miami Miller School of Medicine, Miami; July 21, 2014, Journal of Investigative Dermatology
by Mary Elizabeth Dallas

Common Genes Implicated in Autism Study

Findings suggest genetics play a bigger role than environment in risk of disorder
SUNDAY, July 20, 2014 (HealthDay News) -- Most of the genetic risk for autism appears to come from common gene variants rather than spontaneous gene mutations, according to a new study.
Researchers compared about 3,000 people in Sweden with and without autism and found that about 52 percent of autism was linked to common gene variants and rare inherited variations. Spontaneous genetic mutations accounted for only 2.6 percent of autism risk.
The investigators also found that genetics seem to play a stronger role in autism risk than environmental factors, according to the study funded by the U.S. National Institutes of Health.
The study, which the researchers said was the largest of its kind to date, was published in the July 20 issue of the journal Nature Genetics.
"From this study, we can see that genetics plays a major role in the development of autism compared to environmental risk factors, making autism more like height than we thought -- many small risk factors add up, each pushing a person further out on the spectrum," co-lead investigator Kathryn Roeder, professor of statistics and computational biology at Carnegie Mellon University in Pittsburgh, said in a university news release.
Autism spectrum disorders describe a range of developmental disabilities that can cause social, communication and behavioral difficulties. About 1 in 68 U.S. children has an autism spectrum disorder, the U.S. Centers for Disease Control and Prevention estimates.
"Genetic variation likely accounts for roughly 60 percent of the liability for autism, with common variants comprising the bulk of its genetic architecture," co-lead investigator Joseph Buxbaum, of the Icahn School of Medicine at Mount Sinai in New York City, said in a news release from the U.S. National Institute of Mental Health (NIMH).
"Although each exerts just a tiny effect individually, these common variations in the genetic code add up to substantial impact, taken together," explained Buxbaum.
Roeder added, "These findings could not have happened without statistics, and now we must build off of what we learned and use statistical approaches to determine where to put future resources, and decide what is the most beneficial direction to pursue to further pinpoint what causes autism."
According to NIMH Director Dr. Thomas Insel, "Knowing the nature of the genetic risk will help focus the search for clues to the molecular roots of the disorder. Common variation may be more important than we thought," he said in the Carnegie Mellon news release.
Buxbaum explained that "within a given family, the mutations could be a critical determinant that leads to the manifestation of [autism] in a particular family member."
He concluded: "The family may have common variation that puts it at risk, but if there is also a [new] mutation on top of that, it could push an individual over the edge. So for many families, the interplay between common and spontaneous genetic factors could be the underlying genetic architecture of the disorder."
More information
The U.S. National Library of Medicine has more about autism (http://www.nlm.nih.gov/medlineplus/autism.html ).
SOURCES: Carnegie Mellon University, news release, July 20, 2014; U.S. National Institute of Mental Health, news release, July 20, 2014
by Mary Elizabeth Dallas

Could Probiotics Help Tame High Blood Pressure?

Study suggests effect from helpful microbes in yogurt, supplements, but more research is needed
MONDAY, July 21, 2014 (HealthDay News) -- A new study suggests that potential help in lowering high blood pressure might be as close as your refrigerator.
The study found that regular intake of probiotics, such as those found in certain yogurts or supplements, may help ease the condition.
Researchers looked at data from nine studies that examined links between probiotics and blood pressure. The studies involved a total of 543 adults with either normal or elevated blood pressure.
People who consumed probiotics had an average reduction in systolic blood pressure (the top number in a reading) of about 3.6 millimeters of mercury (mm Hg) and an average reduction in diastolic blood pressure (the bottom number) of about 2.4 mm Hg, compared to those who did not consume probiotics.
Probiotics' benefits seemed greatest among people with elevated blood pressure (higher than 130/85), and probiotics with multiple types of bacteria lowered blood pressure more than those with a single type of bacteria, the researchers reported.
The study was published July 21 in the journal Hypertension.
Duration of intake seemed key -- people who consumed probiotics for less than two months did not see reductions in blood pressure readings, the study authors noted.
Still, "the small collection of studies we looked at suggest regular consumption of probiotics can be part of a healthy lifestyle to help reduce high blood pressure, as well as maintain healthy blood pressure levels," lead author Jing Sun, of Griffith University in Australia, said in a journal news release.
"This includes probiotics in yogurt, fermented and sour milk and cheese, and probiotic supplements," she said.
The study could only point to an association between increased probiotic intake and lower blood pressure readings, it could not prove cause and effect. And the study authors stressed that further research is needed before doctors can advise patients to take probiotics to lower their blood pressure.
Experts agreed that more research is needed.
"The degree of blood pressure-lowering was modest," noted Dr. Merle Myerson, of the Center for Cardiovascular Disease Prevention of Mount Sinai Roosevelt and St. Luke's in New York City.
And she added that the study had limitations, because "the amount of probiotic consumed varied from study to study," and other -- perhaps beneficial -- items in the participants' diets weren't always uniformly measured.
However, "despite these limitations, the results are useful in suggesting where further research should be directed," Myerson said.
Dr. Bruce Rutkin is a cardiologist at North Shore University Hospital in Manhasset, N.Y. He said that "prior studies have demonstrated that probiotics and their products may favorably impact blood pressure through a variety of mechanisms." Those include a lowering of blood levels of LDL "bad" cholesterol and helping to control blood sugar and reduce insulin resistance -- a key player in diabetes.
Rutkin agreed with Myerson that the reduction in blood pressure tied to probiotic products was "modest," but he believes that "in conjunction with a heart-healthy lifestyle, they may play a role in modifying cardiovascular risk."
More information
The U.S. Centers for Disease Control and Prevention explains how to prevent high blood pressure (http://www.cdc.gov/bloodpressure/healthy_living.htm ).
SOURCES: Merle Myerson, M.D., Center for Cardiovascular Disease Prevention, Mount Sinai Roosevelt and Mount Sinai St. Luke's, New York City; Bruce Rutkin, M.D., cardiologist, North Shore University Hospital, Manhasset, N.Y.; Hypertension, news release, July 21, 2014
by Mary Elizabeth Dallas

Good Schools May Be Good for a Teen's Health, Too

Study found lower-income kids at challenging high schools less likely to engage in risky behaviors
MONDAY, July 21, 2014 (HealthDay News) -- Low-income teenagers who get into a more rigorous high school may take fewer health risks than their peers at other schools, a new study suggests.
The study, of low-income Los Angeles teens, found that those who attended "high-performing" high schools were less likely to carry a weapon, binge-drink, have multiple sex partners or take certain other health risks.
And it wasn't just a matter of "good kids" being more likely to go to good schools, researchers said.
The study included teens who had applied to one of three top-performing charter schools in Los Angeles. And those schools used a lottery system to offer admissions -- which is similar to a scientific study where people are randomly assigned to an "intervention" or not.
"We think this is an effect of the schools themselves," said lead researcher Dr. Mitchell Wong, of the University of California, Los Angeles.
Many studies have suggested that kids who go to safe, higher-performing schools fare better -- and not just academically. They also tend to have fewer behavior issues and better mental health.
"But the question has been, is it really the schools or is it all the other things that go with education?" Wong said. Among those "things," he noted, are supportive parents, and friends who care about school and stay out of trouble.
So for the study Wong's team took advantage of what they call a "natural experiment." They surveyed 521 students who had gotten into a high-performing charter high school by the luck of the draw, and compared them with 409 students who had applied to the top schools but didn't win the lottery.
Overall, 36 percent of kids at the charter schools admitted to at least one "very risky" behavior -- such as binge-drinking, carrying a weapon, having unprotected sex, or using drugs other than marijuana. That compared with 42 percent of students at other schools, the study found.
When it came to more common types of risky behavior -- such as lighter drinking, or smoking cigarettes or marijuana -- there was no clear difference between the two groups.
According to Wong, that was unexpected. "We were surprised we didn't see more differences," he said. "But it is encouraging that we found lower rates of very risky behaviors -- the kinds of behaviors you don't want any teenager engaging in."
The findings were published in the July 21 online edition and in the August print issue of the journal Pediatrics.
A researcher who reviewed the study called it a "beautifully conducted natural experiment."
"The findings emphasize the importance of high-performing schools for both academic and health outcomes, which provides even greater imperative to enhance the academic performance of all schools," said Kelli Komro, a professor at the University of Florida, Gainesville, who studies the effects of social factors on kids' health.
It's not completely clear why a higher-performing school would influence teens' risk-taking. But Komro said "positive connections" between teachers and students could be one reason. Plus, she added, those schools may create a "culture of high expectations" when it comes to student behavior.
Wong's team found that two factors seemed key in explaining the lower rate of very risky behavior: Kids at high-performing high schools were less likely to switch schools or drop out, and they generally scored higher in standardized English and math tests.
Wong said it's possible that kids who fare better academically feel more "hopeful" about the future, make better choices -- or may be too busy with homework to get into trouble.
Whatever the reasons, he said, "we think this shows that schools do more than teach reading and math. They may have a strong impact on how students behave outside of school."
Wong added that any high-performing school might have such an impact; his team studied charter schools because of their lottery system. "We don't think there's anything magical about charter schools," he said.
He added that future research should look into the long-term health effects of attending a higher-performing school -- since those kids may get better jobs and lead healthier lives.
"The biggest effects of education might happen later, in adulthood," Wong said.
More information
The U.S. Centers for Disease Control and Prevention has more on schools and kids' health (http://www.cdc.gov/HealthyYouth/health_and_academics/index.htm#1 ).
SOURCES: Mitchell Wong, M.D., Ph.D., associate professor, medicine, University of California, Los Angeles; Kelli Komro, Ph.D., M.P.H., associate director, Institute for Child Health Policy, University of Florida, Gainesville, Fla.; July 21, 2014, Pediatrics, online
by Mary Elizabeth Dallas

Health Highlights: July 21, 2014

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:
Videotaping Ob/Gyn Costs Hopkins $190 Million
Johns Hopkins Hospital in Baltimore has settled a sexual misconduct case involving a secret-camera-wielding gynecologist and 8,000 unsuspecting female patients for $190 million, the Associated Press reported.
Lawyers said Dr. Nikita Levy, fired in February 2013, wore a camera disguised as a pen around his neck and secretly videotaped and photographed women in the examining room, according to the AP.
Another employee of the Baltimore hospital employee brought concerns about Levy's behavior to hospital authorities who insisted Levy surrender his camera. Ten days later, he killed himself. It was reported that about 1,200 videos and 140 images were stored on servers in his home.
"All of these women were brutalized by this," said the women's lead attorney, Jonathan Schochor, the AP reported. "Some of these women needed counseling, they were sleepless, they were dysfunctional in the workplace, they were dysfunctional at home, they were dysfunctional with their mates. This breach of trust, this betrayal - this is how they felt."
The women's faces weren't visible in the image, and investigators said they found no evidence that Levy had transmitted the images to others.
Fruit Recalled for Possible Listeria Contamination
Packaged fresh fruit sold at Costco, BJ's, Trader Joe's and other retailers has been recalled because of concerns of possible contamination with the life-threatening bacteria listeria, according to published reports.
The voluntary recall includes peaches, plums, nectarines and pluots -- apricot-plum hybrids -- packaged between June 1 and July 12 by Wawona Packing Co. of California, WPIX-TV in New York City reported.
"Because we do not know the locations of the companies that purchased the products from our direct customers, the company is issuing a nationwide recall," Wawona said in a news release Sunday.
Wawona said internal testing discovered traces of the virulent bacteria, but no illnesses have been reported.
Since the discovery, the company said it has retrofitted and cleaned packing lines and equipment connected with the possible contamination. It also said subsequent daily testing has been negative, according to the news report.
The items affected by the recall include peaches, nectarines, plums and pluots sold in clamshell-type packages of six. If you bought the fruit, throw it away immediately. Consumers with questions can call Wawona Packing at 1-888-232-9912 or check www.wawonapacking.com.
Listeriosis -- the illness caused by L. monocytogenes bacteria -- causes fever and chills, headache, upset stomach and vomiting, according to the U.S. National Institutes of Health. It is most likely to affect pregnant women and unborn babies, older adults, and people with weakened immune systems. Treatment is with antibiotics.
FDA Warns Against Use of Powdered Caffeine
The death of an Ohio teen on May 27 after ingesting pure powdered caffeine is spurring the U.S. Food and Drug Administration to warn against its use.
According to the agency, 18-year-old Logan Stiner, of Lagrange, died after consuming caffeine powder, which can be obtained over the Internet.
As reported by the Associated Press, the FDA said that even a teaspoon of the product can be deadly. However, FDA spokeswoman Jennifer Dooren told the news service that caffeine's ubiquitous presence in coffee, tea or soda may lull people into forgetting that it is a powerful chemical.
"The difference between a safe amount and a lethal dose of caffeine in these powdered products is very small," Dooren said, and measuring out amounts via a teaspoon is inaccurate and hazardous.
The FDA says labeling on caffeine powder products is often insufficient, so consumers may not realize the risk of overdose. The agency says it will "consider taking regulatory action" to control the products.
Symptoms of caffeine overdose include seizures, vomiting, rapid or erratic heartbeat, diarrhea and disorientation, the FDA said.
Actor James Garner Dies at 86
James Garner, a Hollywood actor who starred in both movies and television shows during his long career, died Saturday night at his home in Los Angeles.
He was 86 and died of natural causes, according to his publicist Jennifer Allen.
Garner played the handsome leading man in countless Hollywood films. But he's perhaps best known for his television roles, as Bret Maverick in the 1950s western "Maverick" and as the sleuth Jim Rockford in the 1970s series "The Rockford Files," The New York Times reported.
Garner received an Academy Award nomination late in his career, for the 1985 romantic comedy "Murphy's Romance." In that film, he played a pharmacist in a small town who tries to win the heart of a divorced mother (Sally Field), the Times reported.
During the filming of "The Rockford Files," Garner had back trouble and had to have several knee operations. In 1988, he had a quintuple bypass operation, which cost him his job as spokesman for the beef industry, the newspaper reported.
by Mary Elizabeth Dallas

HIV Diagnoses Down in U.S., Except for Young Gay Males: CDC

Messages about safe sex may be falling on deaf ears, researcher notes
SATURDAY, July 19, 2014 (HealthDay News) -- A new report offers good and bad news about the AIDS epidemic in the United States: The annual diagnosis rate of HIV, the virus that causes the disease, has dropped by one-third in the general population but has climbed among young gay and bisexual males.
Significantly fewer heterosexuals, drug users and women were diagnosed each year with HIV, according to the report from the U.S. Centers for Disease Control and Prevention. However, the annual diagnosis rate more than doubled for young gay and bisexual males.
The push for safer sex may be falling on deaf ears in a generation too young to have seen the ravages of AIDS, said report co-author Amy Lansky, deputy director for surveillance, epidemiology and laboratory sciences at the CDC's Division of HIV/AIDS Prevention.
"It's been more than 30 years since the first cases were reported," she said. "It's harder to maintain that sense of urgency."
The report only looked at people diagnosed with HIV, and health officials think many more are infected with the virus but don't know it. The statistics also don't say anything about when these people were infected, making it hard to pinpoint trends in efforts to prevent transmission of the virus.
Still, "we're making significant progress and seeing declines overall," said Lansky. However, she added, the rising numbers of diagnoses among young men who have sex with other men are "a considerable problem."
The AIDS epidemic began more than 30 years ago. While the last two decades have brought great advances in drugs that prevent AIDS from developing in HIV-positive people, an estimated 1.1 million people are still living with HIV in the United States, Lansky said. Officials believe about 16 percent of those people -- or about 176,000 -- don't know they're infected, she said.
In the new report, published in the July 23/30 issue of the Journal of the American Medical Association, researchers examined HIV diagnoses in the United States from 2002 to 2011 in people aged 13 and older.
Although almost 500,000 people were diagnosed with HIV during that time, the annual rate of diagnoses fell from 24 out of every 100,000 people to 16 -- a decline of 33 percent.
Many groups experienced significant declines in infection.
Among women, diagnosis rates dropped by about half, and among men by more than one-quarter. For blacks and Hispanics, the rates of diagnosis declined 37 percent and 41 percent, respectively.
The report estimates that HIV infections due to injection drug use fell by roughly 70 percent and from heterosexual contact by more than one-third for men and women.
Distribution of sterile needles, increased HIV testing and drug-treatment programs could explain some of the downward trend, Lansky said.
But the diagnosis rate jumped among males aged 13 to 24, suggesting that many gay and bisexual young men aren't using condoms during sex. The number of newly diagnosed cases in that age group rose from about 3,000 to about 7,000, Lansky said.
What's next?
"The increases tell us where we need to keep putting our efforts," Lansky said. "To build on the progress that we've made, we're really starting to focus on those who are in greatest need."
Dr. David Margolis, an AIDS specialist at the University of North Carolina at Chapel Hill, said one way to do that is to promote use of HIV drugs by people who are at risk but not infected. "Pre-exposure" treatment is controversial, however, because some experts fear it might encourage users to have more unprotected sex.
"The use of antivirals to prevent HIV infection is fraught with many challenges," Margolis said, "but if there is a more than doubling of new infections in one demographic, perhaps something needs to be done."
More information
The University of California, San Francisco has more about diagnosing HIV (http://www.ucsfhealth.org/conditions/hiv/diagnosis.html ).
SOURCES: Amy Lansky, Ph.D., MPH, deputy director for surveillance, epidemiology and laboratory sciences, Division of HIV/AIDS Prevention, U.S. Centers for Disease Control and Prevention, Atlanta; David Margolis, M.D., professor, medicine, microbiology and immunology, epidemiology, School of Medicine, and director, program in translational clinical research, Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill; July 23/30, 2014, Journal of the American Medical Association
by Mary Elizabeth Dallas

Irregular Heart Rhythm Ups Stroke Risk Soon After Heart Surgery

Older age, past stroke among factors that boost short and long-term odds of post-op stroke, study finds
MONDAY, July 21, 2014 (HealthDay News) -- People who are older than 65 who've had a stroke or heart valve surgery, or who have known blood vessel disease, have an increased risk of stroke after heart surgery, a new study finds.
Researchers looked at nearly 109,000 heart surgery patients in the Canadian province of Ontario and found that those factors could up the risk of stroke immediately after and for as long as two years following heart surgery.
Having a heart rhythm disorder called atrial fibrillation also increased the risk of stroke, but only immediately after heart surgery, according to the study in the July 21 issue of the Canadian Medical Association Journal.
The researchers also found that patients with a higher number on the CHADS2 score -- a tool used by doctors to determine a patient's risk of stroke -- are at increased risk of stroke with or without atrial fibrillation.
"The rate of stroke or death in the absence of any atrial fibrillation was 5.8 percent among patients with a CHADS2 score of 0 or 1, as compared with 14.8 percent among those with a higher score," wrote Dr. Richard Whitlock, from McMaster University, Hamilton, Ontario, and colleagues in a journal news release.
"In the group of patients who had a history of atrial fibrillation, the rate of stroke or death at 2 years was 9.3 percent among those with a CHADS2 score of 0 or 1, as compared with 19.9 percent among those with a higher score."
The researchers noted that stroke is a significant complication after surgery, and that their study improves understanding of stroke risk in heart surgery patients.
Although the study found an association between these factors and the risk of stroke, it wasn't designed to prove whether or not these factors were directly responsible for strokes after heart surgery.
More information
The U.S. National Heart, Lung, and Blood Institute has more about heart surgery (http://www.nhlbi.nih.gov/health/health-topics/topics/hs/ ).
SOURCE: Canadian Medical Association Journal , news release, July 21, 2014
by Mary Elizabeth Dallas

Scientists Snipped HIV Out of Human DNA

Molecular tool might lead to more definitive treatment, but current research didn't treat patients, just cells
MONDAY, July 21, 2014 (HealthDay News) -- A recently developed molecular tool allowed researchers to remove HIV from cultured human cells in the lab.
The team of scientists at Temple University School of Medicine in Philadelphia said their approach may one day lead to a permanent treatment for HIV. They added that this technique might also be used to develop a vaccine to offer protection against the disease in the future.
"Since HIV-1 is never cleared by the immune system, removal of the virus is required in order to cure the disease," Kamel Khalili, chair of the department of neuroscience at Temple, explained in a university news release.
"It's an exciting discovery, but it's not yet ready to go into the clinic. It's a proof of concept that we're moving in the right direction," added Khalili, who is also director of the Comprehensive NeuroAIDS Center at Temple.
The study was published online July 21 in the Proceedings of the National Academy of Sciences.
The research focused on a type of HIV known as HIV-1. This is the most common type of AIDS-causing HIV worldwide, according to the U.S. Centers for Disease Control and Prevention. The virus inserts its genetic material into the DNA of human cells, where it remains throughout a person's lifetime.
That means people with HIV-1 must take a drug regimen for the rest of their lives to keep the virus under control. If treatment is stopped, the virus returns.
But, if it were possible to remove HIV's genetic material from human cells, the researchers believe they might be able to rid people of the virus for good.
To do this, the researchers developed a molecular tool that could hunt down HIV-1's genetic material and snip it out of human cells. Once the viral DNA was removed, the cells were able to repair themselves and put loose ends back together. The result: virus-free cells.
This deletion process was successful in several types of human cells known to harbor HIV-1, according to Khalili.
This technique could potentially be used against a variety of other viruses, the study's authors pointed out. They also suggested that the same molecular tools used to remove HIV genetic material might lead to an HIV vaccine. The treated cells, which were armed with the ability to snip out HIV, were resistant to new HIV infection, the study revealed.
There are still many challenges associated with this approach that researchers must overcome before it could be used on people, including how to deliver the agent to every single infected cell. HIV-1 also tends to mutate, the researchers noted. As a result, treatment may need to be individualized to each person.
More than 33 million people around the world have HIV, including more than 1 million in the United States. Each year, 50,000 Americans are infected with the virus, according to the CDC.
More information
The U.S. Department of Health and Human Services provides more information on HIV/AIDS (http://www.aids.gov/hiv-aids-basics/ ).
SOURCE: Temple University Health System, news release, July 21, 2014

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